Kaiser Permanente research shows the need to
raise awareness about the dangers of high blood pressure.
March 29, 2021
PRESS RELEASE
Contact: Susan Rochman
susan.l.rochman@kp.org
510-271-6328
Contact:
Kerry Sinclair
ksinclair@webershandwick.com
310-710-0321
OAKLAND,
Calif. — Black middle-aged adults had an incidence rate of stroke 4 times
higher than that of white middle-aged adults, according to a Kaiser Permanente
study published March 29 in Hypertension.
The
large national prospective study highlights the need to raise awareness among
young and middle-aged Black adults about the impact of high blood pressure,
called hypertension, on stroke, the research team said.
“What
we found striking in this study was that the incidence of stroke began to
increase rapidly starting at around age 40 for Black adults,” said the study’s
co-author Jamal S. Rana, MD, PhD, an adjunct
investigator with the Division of Research at Kaiser Permanente in Northern
California, and cardiologist with The Permanente Medical Group. “It is well
known that Black adults have higher rates of hypertension in general, but the
fact that their blood pressure levels are starting to increase at such an early
stage in life is concerning.”
The
research used data collected in the Coronary
Artery Risk Development in Young Adults study. Launched in
1985, CARDIA enrolled 5,115 Black and white women and men ages 18 to 30 at
research hospitals in 4 cities. Blood pressure measurements and other tests
were performed when participants entered the study, and were conducted every 5
years, with 2 additional exams at years 2 and 7.
This
analysis included data collected on 5,079 participants starting from 1990
through 2018. In 1990, the Black adults already had higher rates of elevated
blood pressure and diagnosed hypertension than the white adults. By 2018, 100
people in the study had had a stroke, at a median age of 49.8. The stroke
incidence rate was 29 per 100,000 person-years for white adults compared with
120 per 100,000 person-years for Black adults — a rate more than 4 times
higher. A person-year is a measurement that takes into account the number of
people in a study and the amount of time each person spends in the study.
The analysis also took into account other risk factors for stroke, such as
smoking, diabetes, high cholesterol, obesity, lack of physical activity, and
excessive alcohol use.
“This
study confirms that it’s not only whether you have high blood pressure but how
long you have had high blood pressure and how long the damage to the blood
vessels has been occurring that matters,” said the study’s senior author Stephen Sidney, MD, MPH, a research scientist
at the Kaiser Permanente Division of Research. “It also tells us that
interventions need to be put in place to prevent high blood pressure from ever
even occurring.”
The
study’s first author Yariv Gerber, PhD, a professor of epidemiology
and head of the School of Public Health at Tel Aviv University in Israel,
conducted the research while on a sabbatical at the Kaiser Permanente Division
of Research. “We demonstrated that the association of high blood pressure with
stroke varies with age, strengthening from young adulthood to midlife,” said
Dr. Gerber. “The association was also dynamic, with the most recent measurement
most strongly associated with subsequent stroke risk. This stresses the need for
early public health interventions to maintain optimal blood pressure levels in
young adulthood, particularly in high-risk Black young adults.”
Previous
research suggests young adults age 18 to 39 in the United States are less aware than adults age 40 and
older about what their blood pressure numbers mean and why it is important to
keep blood pressure low. “Anytime you talk about abnormal blood pressure, the
biggest challenge is always that people are not feeling it in real time,” said
Dr. Rana. “It is not until a person’s blood pressure has been out of control
for a prolonged period of time that they feel any symptoms. Our goal should be
to have people proactively think about blood pressure control.”
The
study was supported by the National Heart, Lung, and Blood Institute.
Co-authors
include Mai N. Nguyen-Huynh, MD, MAS, of the Division
of Research; David R. Jacobs Jr., PhD, of the University of Minnesota; Yuichiro
Yano, PhD, of Duke University; Deborah Levine, MD, MPH, of the University of
Michigan, Ann Arbor; Joao A.C. Lima, MD, MBA, of the Johns Hopkins School of
Medicine; Jared P. Reis, PhD, of the National Heart, Lung, and Blood Institute;
Lihui Zhao, PhD, and Kiang Liu, PhD, of Northwestern University; and Cora E.
Lewis, MD, MSPH, of the University of Alabama.
About Kaiser Permanente
Kaiser
Permanente is committed to helping shape the future of health care. We are
recognized as one of America’s leading health care providers and not-for-profit
health plans. Founded in 1945, Kaiser Permanente has a mission to provide
high-quality, affordable health care services and to improve the health of our
members and the communities we serve. We currently serve 12.4 million members
in 8 states and the District of Columbia. Care for members and patients is
focused on their total health and guided by their personal Permanente Medical
Group physicians, specialists, and team of caregivers. Our expert and caring
medical teams are empowered and supported by industry-leading technology
advances and tools for health promotion, disease prevention, state-of-the-art
care delivery, and world-class chronic disease management. Kaiser Permanente is
dedicated to care innovations, clinical research, health education, and the
support of community health.
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